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NRC:Improving Healthcare for Cognitively Impaired Elders and Their Caregivers (RDAD&APNs)

Primary Purpose

Alzheimer Disease, Nurse Training

Status
Unknown status
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
RDAD Training
Sponsored by
University of Washington
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional health services research trial for Alzheimer Disease

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Licensed by the Washington state Department of Health as an Advanced Registered Nurse Practitioner (ARNP),
  • Hold a board certification as a Gerontological Nurse Practitioner, Adult Nurse Practitioner, or Family Nurse Practitioner,
  • Work at least half time (0.50 FTE) in a clinical setting (primary care, internal medicine, sub-specialty, medical home), with a panel consisting of over 25% of patients over 65 years of age,
  • Have no expectation for termination over the course of the study; and
  • Agree to participate in all phases of the RDAD translational program.

Exclusion Criteria:

  • NA

Sites / Locations

  • University of WashingtonRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

RDAD training to APNs

Arm Description

Half-day workshop to provide APNs with all skills necessary to conduct RDAD in their clinical settings. A subset of the trained APNs will implement RDAD as part of their ongoing care of persons with ADRD.

Outcomes

Primary Outcome Measures

Physician Confidence in Dementia Care Skills
A 12-item self-report measure (administered to ARNPs) designed to measure perception of ability to address the care needs of patients with ADRD.
Sense of Competence in Dementia
A 17-item questionnaire covering 4 domains: job satisfaction, attitude towards dementia, work experience, and level of dementia knowledge.
Dementia Attitudes Scale
A 20-item scale to measures attitudes towards dementia with a two-factor structure; "dementia knowledge" and "social comfort".

Secondary Outcome Measures

Focus Group Questions
Questions to determine satisfaction with a acceptability of RDAD
Implementation Questions
Questions to determine Acceptability of RDAD

Full Information

First Posted
September 14, 2017
Last Updated
May 9, 2018
Sponsor
University of Washington
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1. Study Identification

Unique Protocol Identification Number
NCT03289377
Brief Title
NRC:Improving Healthcare for Cognitively Impaired Elders and Their Caregivers
Acronym
RDAD&APNs
Official Title
NRC: Improving Healthcare for Cognitively Impaired Elders and Their Caregivers
Study Type
Interventional

2. Study Status

Record Verification Date
May 2018
Overall Recruitment Status
Unknown status
Study Start Date
February 1, 2018 (Actual)
Primary Completion Date
October 2018 (Anticipated)
Study Completion Date
October 2018 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Washington

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
An multi-stage mixed-method design will be employed to obtain both qualitative and quantitative data to address two study aims: (1) Evaluate and refine the delivery Reducing Disabilities in Alzheimer's Disease (RD- AD) training to advanced practice nurses and (2) Evaluate and refine the implementation of RD-AD by advanced practice nurses in their medical settings.
Detailed Description
Two waves of APNs (25 each wave/total 50) will receive RDAD training and be queried pre and post- training using both qualitative and quantitative procedures to determine: (1) Is RDAD training successfully received by advanced practice nurses? (2) Do they report it as relevant to improving the care they deliver to persons with Alzheimer's Disease and Related Dementias (ADRD)? (3) Does RDAD training of advanced practice nurses improve their level of knowledge about ADRD, their skills in providing ADRD care, and their level of confidence in providing this care? A subset of advanced practice nurses (5 per wave, total of 10) will be recruited to implement RDAD as part of their ongoing care of persons with ADRD.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer Disease, Nurse Training

7. Study Design

Primary Purpose
Health Services Research
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
RDAD training to APNs
Arm Type
Experimental
Arm Description
Half-day workshop to provide APNs with all skills necessary to conduct RDAD in their clinical settings. A subset of the trained APNs will implement RDAD as part of their ongoing care of persons with ADRD.
Intervention Type
Behavioral
Intervention Name(s)
RDAD Training
Intervention Description
An interactive processes of lecture, role-play, and discussion, APNs will have the opportunity to dissect all phases of RDAD to insure they understand the objectives, can enact the program, and feel confident they can problem-solve situations that arise. APNs will receive materials to insure they are knowledgeable about ADRD symptoms, behavior management techniques, and exercise safety.
Primary Outcome Measure Information:
Title
Physician Confidence in Dementia Care Skills
Description
A 12-item self-report measure (administered to ARNPs) designed to measure perception of ability to address the care needs of patients with ADRD.
Time Frame
Change from baseline score at 2 months
Title
Sense of Competence in Dementia
Description
A 17-item questionnaire covering 4 domains: job satisfaction, attitude towards dementia, work experience, and level of dementia knowledge.
Time Frame
Change from baseline score at 2 months
Title
Dementia Attitudes Scale
Description
A 20-item scale to measures attitudes towards dementia with a two-factor structure; "dementia knowledge" and "social comfort".
Time Frame
Change from baseline score at 2 months
Secondary Outcome Measure Information:
Title
Focus Group Questions
Description
Questions to determine satisfaction with a acceptability of RDAD
Time Frame
At 2 months
Title
Implementation Questions
Description
Questions to determine Acceptability of RDAD
Time Frame
At 2 months

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Licensed by the Washington state Department of Health as an Advanced Registered Nurse Practitioner (ARNP), Hold a board certification as a Gerontological Nurse Practitioner, Adult Nurse Practitioner, or Family Nurse Practitioner, Work at least half time (0.50 FTE) in a clinical setting (primary care, internal medicine, sub-specialty, medical home), with a panel consisting of over 25% of patients over 65 years of age, Have no expectation for termination over the course of the study; and Agree to participate in all phases of the RDAD translational program. Exclusion Criteria: NA
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Christine A Coulter, Ph.D.
Phone
206-685-9169
Email
cac76@uw.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Amy L Cunningham, M.S.
Phone
206-616-5550
Email
amoore@uw.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Linda Teri, Ph.D.
Organizational Affiliation
University of Washington
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Washington
City
Seattle
State/Province
Washington
ZIP/Postal Code
98195
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Amy Moore Cunningham, MS
Phone
206-616-5550
Email
amoore@u.washington.edu
First Name & Middle Initial & Last Name & Degree
Linda Teri, Ph.D.

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
14559955
Citation
Teri L, Gibbons LE, McCurry SM, Logsdon RG, Buchner DM, Barlow WE, Kukull WA, LaCroix AZ, McCormick W, Larson EB. Exercise plus behavioral management in patients with Alzheimer disease: a randomized controlled trial. JAMA. 2003 Oct 15;290(15):2015-22. doi: 10.1001/jama.290.15.2015.
Results Reference
background
PubMed Identifier
22952073
Citation
Brodaty H, Arasaratnam C. Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. Am J Psychiatry. 2012 Sep;169(9):946-53. doi: 10.1176/appi.ajp.2012.11101529. Erratum In: Am J Psychiatry. 2013 Feb 1;170(2):227.
Results Reference
background
PubMed Identifier
9343469
Citation
Small GW, Rabins PV, Barry PP, Buckholtz NS, DeKosky ST, Ferris SH, Finkel SI, Gwyther LP, Khachaturian ZS, Lebowitz BD, McRae TD, Morris JC, Oakley F, Schneider LS, Streim JE, Sunderland T, Teri LA, Tune LE. Diagnosis and treatment of Alzheimer disease and related disorders. Consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society. JAMA. 1997 Oct 22-29;278(16):1363-71.
Results Reference
background
PubMed Identifier
20126958
Citation
Koch T, Iliffe S; Evidem Programme. The role of primary care in the recognition of and response to dementia. J Nutr Health Aging. 2010 Feb;14(2):107-9. doi: 10.1007/s12603-010-0021-1. No abstract available.
Results Reference
background
PubMed Identifier
12433261
Citation
Kukull WA, Higdon R, Bowen JD, McCormick WC, Teri L, Schellenberg GD, van Belle G, Jolley L, Larson EB. Dementia and Alzheimer disease incidence: a prospective cohort study. Arch Neurol. 2002 Nov;59(11):1737-46. doi: 10.1001/archneur.59.11.1737.
Results Reference
background
PubMed Identifier
15860472
Citation
Bruce DG, Paley GA, Nichols P, Roberts D, Underwood PJ, Schaper F. Physical disability contributes to caregiver stress in dementia caregivers. J Gerontol A Biol Sci Med Sci. 2005 Mar;60(3):345-9. doi: 10.1093/gerona/60.3.345.
Results Reference
background
PubMed Identifier
20808108
Citation
Mohamed S, Rosenheck R, Lyketsos CG, Schneider LS. Caregiver burden in Alzheimer disease: cross-sectional and longitudinal patient correlates. Am J Geriatr Psychiatry. 2010 Oct;18(10):917-27. doi: 10.1097/JGP.0b013e3181d5745d.
Results Reference
background
PubMed Identifier
18591579
Citation
Tun SM, Murman DL, Colenda CC. Concurrent validity of neuropsychiatric subgroups on caregiver burden in Alzheimer disease patients. Am J Geriatr Psychiatry. 2008 Jul;16(7):594-602. doi: 10.1097/JGP.0b013e318173f5fc.
Results Reference
background
PubMed Identifier
17578574
Citation
Gaugler JE, Duval S, Anderson KA, Kane RL. Predicting nursing home admission in the U.S: a meta-analysis. BMC Geriatr. 2007 Jun 19;7:13. doi: 10.1186/1471-2318-7-13.
Results Reference
background
Links:
URL
http://www.cms.gov/PrevntionGenInfo/20_prevserv.asp
Description
Medicare data claims data Baltimore, MD
URL
http://www.cdc.gov/pcd/issues/2006/apr/05_0167.htm
Description
Dementia and its implications for public health 2006

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NRC:Improving Healthcare for Cognitively Impaired Elders and Their Caregivers

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